Page:United States Statutes at Large Volume 124.djvu/971

124 STAT. 945 PUBLIC LAW 111–148—MAR. 23, 2010 providing ongoing access to care to low-income Medicare bene- ficiaries or beneficiaries in medically underserved areas, and in treating beneficiaries with varying levels of severity of ill- ness. In conducting the study, the Secretary may analyze items such as the following: ‘‘(A) Methods to potentially revise the home health prospective payment system under section 1895 of the Social Security Act (42 U.S.C. 1395fff) to account for costs related to patient severity of illness or to improving bene- ficiary access to care, such as— ‘‘(i) payment adjustments for services that may involve additional or fewer resources; ‘‘(ii) changes to reflect resources involved with pro- viding home health services to low-income Medicare beneficiaries or Medicare beneficiaries residing in medically underserved areas; ‘‘(iii) ways outlier payments might be revised to reflect costs of treating Medicare beneficiaries with high levels of severity of illness; and ‘‘(iv) other issues determined appropriate by the Secretary. ‘‘(B) Operational issues involved with potential implementation of potential revisions to the home health payment system, including impacts for both home health agencies and administrative and systems issues for the Centers for Medicare & Medicaid Services, and any possible payment vulnerabilities associated with implementing potential revisions. ‘‘(C) Whether additional research might be needed. ‘‘(D) Other items determined appropriate by the Sec- retary. ‘‘(2) CONSIDERATIONS.—In conducting the study under para- graph (1), the Secretary may consider whether patient severity of illness and access to care could be measured by factors, such as— ‘‘(A) population density and relative patient access to care; ‘‘(B) variations in service costs for providing care to individuals who are dually eligible under the Medicare and Medicaid programs; ‘‘(C) the presence of severe or chronic diseases, which might be measured by multiple, discontinuous home health episodes; ‘‘(D) poverty status, such as evidenced by the receipt of Supplemental Security Income under title XVI of the Social Security Act; and ‘‘(E) other factors determined appropriate by the Sec- retary. ‘‘(3) REPORT.—Not later than March 1, 2014, the Secretary shall submit to Congress a report on the study conducted under paragraph (1), together with recommendations for such legisla- tion and administrative action as the Secretary determines appropriate. ‘‘(4) CONSULTATIONS.—In conducting the study under para- graph (1), the Secretary shall consult with appropriate stake- holders, such as groups representing home health agencies and groups representing Medicare beneficiaries.